Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Fatima Funderburk, LCSWA

Individual provider Clinical Social Worker · NPI 1639703804

Fatima Funderburk, LCSWA is a Clinical Social Worker in Raleigh, North Carolina. Qualified in 2019, 7 years ago. Practices as a sole proprietor and works from 2 locations. Licensed in North Carolina.

Years since qualifying
7
Licensed in
NC
In the registry since
2020
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Practice location Address checks out

2411 Tony Tank Ln Apt 301
Raleigh, NC 27613-3860
Phone: (336) 934-2327
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 2231 E Millbrook Rd Ste 101, Raleigh, NC 27604-1746 — (919) 307-8165

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence C018940 (NC)

Record details

NPI number1639703804
Entity typeIndividual (Type 1)
GenderFemale
Credentials LCSWA
Sole proprietorYes
NPI enumeratedFebruary 26, 2020
Last updated in NPPESSeptember 9, 2025
Certification dateSeptember 9, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Accepts Medicare assignment Not indicated
Practice locations3 on file with Medicare

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